1. What are the evidence-based guidelines regarding tuberculosis screening for populations with existing chronic conditions?
Five guidelines were identified that provide recommendations about screening for tuberculosis in people with chronic conditions. These guidelines cover populations with HIV, psoriasis vulgaris, solid organ and stem transplants, chronic inflammation, and compromised immune systems. Three guidelines recommend regularly screening for latent and active tuberculosis in people diagnosed with HIV or those taking medication that suppresses their immune system. One guideline for patients with psoriasis recommends using interferon-gamma release assay and a chest X-ray to rule out tuberculosis infection before immunosuppressant treatment is initiated and during treatment. Two guidelines recommend using both the interferon-gamma release assay and the tuberculin skin test at the same time to screen for latent tuberculosis infection in people with HIV, people with or who need an organ or stem cell transplant, and in people taking medication that suppresses their immune system. One guideline for people living with HIV recommends using a rapid nucleic acid amplification test to confirm clinical suspicions of active tuberculosis in these patients.